Public Health Community Advisory – “Finding a Voice” (FAV) is a project with homeless guests, recovering addicts, and a variety of health professions students learning together.
The head count of homeless guests for one night in January 2013 was 1,530 in the Omaha metropolitan area. The Siena/Francis House (SFH), the largest homeless shelter in the community, serving 450 daily, houses many of the metropolitan area’s homeless people. This unique shelter has an unconditional acceptance policy and also houses a residential addiction recovery program, the Miracles Treatment Program.
FAV was developed in 2008 as a partnership between SFH and the Service-Learning Academy (SLA) in the College of Public Health (COPH) at the University of Nebraska Medical Center (UNMC). This service-learning program brings together homeless guests, recovering addicts, and UNMC health profession students (from nursing, public health, and medicine) to form an open and safe community where all participants find their voice. Students interact with guests and addicts as equals in a weekly Creative Workshop that raises awareness about the complexity of homelessness, dispels stereotypes, and builds relationships. The FAV program also utilizes community-based participatory research principles to engage with the homeless community on a meaningful level. Former and current guests of the SFH are an integral part of the planning team and inform program development and implementation. The FAV philosophy is to acknowledge that all individuals’ perceptions and voices are important and should be shared and heard. The Thursday Creative Workshop, the Saturday Artist in Recovery program, and the Turtle project (Sundays, for children and mothers), are all FAV projects that provide that opportunity to homeless guests and students alike.
Through interviews conducted with the FAV program, guests revealed their top perceived health needs which were very similar to what providers at the shelter clinic identified: mental health, musculoskeletal pain, and addressing addictions. Reported barriers to utilization of health care services included lack of health insurance, mental illness/addictions, and availability of specialty care.
A student participant in the FAV project said “It has already shown me that everyone is human and that we all have a ‘voice’ that should be heard. When caring for patients, I need to be open to fully understanding my patients’ desires and be their advocate. Also, being human, I do find myself trying to assess, categorize, and stereotype (without intention). Overall, I have learned that you should view others and all situations through multiple lens or perspectives to limit false assumptions or interpretation.”
A homeless guest participant in the FAV project said “FAV gave me the strength to be honest with myself and others about my situation. It freed me from my strife and gave me my voice back. FAV is something that I will be eternally grateful for and affected by.”
Forming relationships with guests is critical to better understand homelessness, to assess specific health needs, and to develop appropriate interventions.
To learn more, check out this link: https://blog.unmc.edu/sla/siena-francis/
This article was written by Ruth Margalit, MD, associate professor in the UNMC COPH Department of Health Promotion, Social and Behavioral Health, director of the UNMC COPH Service-Learning Academy, and director of the Finding a Voice project; Laura Vinson, MPH, coordinator in the UNMC COPH Service-Learning Academy; Shinobu Watanabe-Galloway, PhD, associate professor in the UNMC COPH Department of Epidemiology; and Jacqueline Hill, community health nurse practitioner in the UNMC COPH Center for Reducing Health Disparities.